Neurology
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Two patients with acute onset of profound weakness and loss of muscle bulk during a critical illness had unusual histopathological changes of type II myofibers. Both patients had respiratory failure and prolonged neuromuscular blockade. ⋯ Muscle biopsies at days 30 to 32 demonstrated widespread atrophy, basophilic cytoplasm, and vesicular nuclei, features suggestive of regeneration involving virtually all type II myofibers and sparing type I myofibers. This may be another variant or critical illness myopathy or a variation of the pathology during the course of illness.